Technology Enhanced Substance Use and HIV Service Navigation for Sexual and Gender Minority Young Adults Surveilled by the Carceral System

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Project Summary/Abstract There is a strong scientific premise for the study of integrated substance use disorders (SUDs) and HIV- prevention interventions for individuals surveilled by the carceral system (CS). SUDs lead to increased rates of CS involvement as well as increased risk for HIV-acquisition. Estimates of the proportion of the CS-involved population with a SUD reach 72%, and ~150,000 persons with HIV pass through a detention facility annually. Individuals with a self-reported sexual or gender minority (SGM) identity are overrepresented in the CS, and experience well established HIV and substance use inequities. Although pre-exposure prophylaxis (PrEP) is a proven effective intervention for HIV-prevention, its maximal impact depends on uptake, and adherence among those at high risk. To date, few published studies have examined substance use treatment and HIV-prevention uptake among CS-involved populations, including among SGM adults. Peer-led navigation interventions have demonstrated efficacy in building trust and reducing barriers to healthcare engagement, and hold strong potential to address multiple, and complex barriers to treatment and HIV-prevention linkage for SGMYA surveilled by the CS. eHealth approaches to SUD and HIV prevention also hold promise because they improve access to effective intervention services, particularly for SGM groups and younger people. As a multidisciplinary team with expertise in behavioral health (substance use, mental health, HIV prevention), SGM and CS involved adults, and eHealth enhanced and navigator-led behavioral health interventions, we propose to address notable gaps in the literature by expanding the aims of our parent award to examine the feasibility and acceptability of an eHealth enhanced navigator-led SUD and HIV-prevention referral and linkage intervention for SGMYA surveilled by the CS. Study aims are to: 1) Tailor the content and structure of an eHealth technology-supported navigation intervention for substance use treatment and HIV-prevention (PrEP) services to the unique needs of SGMYA (18 to 29 years) surveilled by the CS; 2) Refine and test the tailored eHealth enhanced, navigator-led substance use treatment and HIV prevention (PrEP) intervention for SGMYA surveilled by the CS, for appropriateness, satisfaction, and fidelity. This administrative supplement appropriately expands the scope of the parent award and will directly inform a future R01 clinical trial study to test the efficacy of the eHealth enhanced navigation intervention for improving uptake of substance use treatment and HIV prevention services for SGMYA impacted by the CS.